Osteoporosis

What is Osteoporosis?

Osteoporosis is a medical condition characterized by weakened bones that are more prone to fractures. Bone density normally decreases with age, but in osteoporosis, this process is accelerated, leading to brittle bones that can break even with minor falls. Osteoporosis is the leading cause of fractures in postmenopausal women and older men.

Risk Factors for Osteoporosis

While anyone can develop osteoporosis, certain factors increase the risk:

• Age: Risk increases as you age, particularly after 50.

• Gender: Women are more likely to develop osteoporosis, especially after menopause.

• Genetics: A family history of osteoporosis or fractures raises the likelihood.

• Body Frame Size: Smaller, thinner individuals have less bone mass to begin with.

• Lifestyle Factors:

  • Diet: Low calcium or vitamin D intake contributes to weak bones.

  • Sedentary Lifestyle: Lack of weight-bearing exercises weakens bones.

  • Alcohol: Excessive alcohol intake.

• Medications: Long-term use of corticosteroids or certain anticonvulsants can reduce bone density.

• Medical Conditions: Such as diabetes mellitus, or any inflammatory rheumatic disease.

How to know if you have Osteoporosis?

Often called the "silent disease," it progresses without symptoms until a fracture occurs, commonly in the hip, spine, or wrist.

Signs to Watch For:

• Loss of height over time.

• A stooped posture or curvature of the spine.

• Sudden, severe back pain (may indicate a vertebral fracture).

Osteoporosis Self-Assessment Tool for Asians (OSTA)

OSTA score = age in years - weight in kg

Example: OSTA score = 55 - 45 = 10 (Medium Risk)

OSTA score	Risk	Recommended Action
>20	High	Consider DXA scan
0-20	Medium	Consider DXA scan if any other risk factor(s) as above for osteoporosis is present
<0	Low	Consider deferring DXA

To diagnose osteporosis, we assess bone mineral density using dual energy X-ray absorptiometry (DXA).

Lifestyle advice for patients at risk

1. Dietary Choices:

   • Ensure adequate calcium intake (1,000 mg/day of elemental calcium for healthy adults 51 years and older, and 800 mg/day for adults 19 to 50 years old*)

   • Get enough vitamin D (51 to 70 years old = 600 IU/day; >70 years old = 800 IU/day^)

   • Include bone-friendly foods like leafy greens, dairy, nuts, and fish.

2. Regular Exercise:

   • Engage in weight-bearing exercises like walking, jogging, or dancing.

   • Incorporate strength training to build muscle and support bone health.

   • Practice balance and flexibility exercises to reduce fall risk.

3. Lifestyle changes:

   • Quit smoking and limit alcohol consumption.

   • Wear proper footwear with good support.

   • Make your home safe by removing tripping hazards and using nonslip mats.

4. Routine Health Checks:

   • Monitor bone density if you have risk factors or are over 50

* Source: Singapore Health Promotion Board

^ Source: Institute Of Medicine